The relationship between an inflammation-based prognostic score (Glasgow Prognostic Score) and changes in serum biochemical variables in patients with advanced lung and gastrointestinal cancer

Brown, D.J.F., Milroy, R., Preston, T. and McMillan, D.C. (2007) The relationship between an inflammation-based prognostic score (Glasgow Prognostic Score) and changes in serum biochemical variables in patients with advanced lung and gastrointestinal cancer. Journal of Clinical Pathology, 60(6), pp. 705-708. (doi:10.1136/jcp.2005.033217)

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Abstract

<p><b>Background:</b> The Glasgow Prognostic Score (GPS), an inflammation-based prognostic score formed from standard thresholds of C reactive protein (CRP) and albumin, has prognostic value in patients with advanced cancer. Little is known about the general biochemical disturbance associated with the systemic inflammatory response in cancer.</p> <p><b>Aim:</b> To examine the relationship between the GPS and blood biochemistry in patients with advanced lung and gastrointestinal cancer.</p> <p><b>Methods:</b> The GPS (albumin <35 g/l = 1 and CRP >10 mg/l = 1 combined to form a prognostic score of 0 (normal) and 1 or 2 (abnormal)) and a variety of biochemical variables were examined in patients (n = 50) with advanced lung or gastrointestinal cancer and in a healthy control group (n = 13).</p> <p><b>Results:</b> The GPS was normal in all the controls, but abnormal in 78% of the cancer group. Serum levels of sodium, chloride, creatine kinase, zinc and vitamin D were lower in the cancer group (all p<0.01), whereas levels of calcium, copper (both p<0.05), alkaline phosphatase, γ-glutamyl transferase (both p<0.001) and lactate dehydrogenase (p<0.10) were raised. In the patient group, with increasing GPS, there was a median reduction in Karnofsky Performance Status (25%), haemoglobin (22%), sodium (3%), zinc (15%) and survival (93%, all p<0.05) and a median increase in white cell count (129%), alkaline phosphatase (217%), γ-glutamyl transferase (371%) and lactate dehydrogenase (130%, all p<0.05). CRP levels were strongly and similarly correlated with alkaline phosphatase and γ-glutamyl transferase, accounting for more than 25% of the variation in their activities.</p> <p><b>Conclusion:</b> Several correlations were seen between biochemical variables and increasing GPS. In particular, chronic activation of the systemic inflammatory response in cancer was associated with increase in γ-glutamyl transferase and alkaline phosphatase activity in patients with advanced lung and gastrointestinal cancer.</p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Preston, Professor Thomas and Milroy, Dr Robert and McMillan, Professor Donald
Authors: Brown, D.J.F., Milroy, R., Preston, T., and McMillan, D.C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:Journal of Clinical Pathology
Publisher:BMJ Publishing Group Ltd.
ISSN:0021-9746
Published Online:27 April 2006

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